n

Kerala’s Tryst

with COVID 19

Psycho social support APP to combat fake news “Break The Chain” Campaign Batting and prepping for foreign arrivals Patient Rout Map Plan C- Preparing for Stage 3

Quarantine Comfort Enhanced internet connectivity Resource Management Mid-day meal delivery Officials Field visits Awareness among migrant workers

Screening

Sanitizer Production COVID Control Teams Use of Robot Contact Tracing Food Security and Nutrition IEC Materials

Social Distancing Checking rail and road entry points Mask production by women SHGs Batting and prepping for foreign arrivals Volunteers for Help

Daily Press Conferences

1 | Kerala’s Tryst with COVID 19

Kerala’s Tryst with COVID 19

Co ntents

 Role of KSDMA

 Role of Health Department  Screening  Contact Tracing  Hospital Based and Home-Based Quarantine  Working with the LSGIS/ Kudumbasree/ Jails/ CBOs For Better Resource Management

 Social Distancing

 Educational Institutions  Food Security and Nutrition  Plan C- Preparing for Stage 3  State Level Corona Virus Control Teams Up  Information Sharing  Break The Chain Campaign

 Screening, Mask Utilization

 Use of Robot  Route Maps  Quarantine Comfort  Psycho-Social Support / Focus on Mental Health  Visits from Govt Officials  Daily Press Conferences

 Increasing Internet Connectivity

 Sanitiser Production  App to Combat Fake News  Mid-Day Meal Delivery  Checking Rail and Road Entry Points  Awareness Among Migrant Workers

 Enlisting Volunteers for Help

 Batting and Prepping for Foreign Arrivals

2 | Kerala’s Tryst with COVID 19

t is, perhaps, rightly said that every reports of the infection in China started disaster is an opportunity. This has been coming in. The initial area of concern was the I proved apt for Kerala, backed by the safe return of the medical students from experience of two successful battles with the Kerala, studying from Wuhan and the Nipah Virus, in its current tryst with the delegates returning from official visits to globally feared Corona Virus or the COVID-19. China. The protocols for screening were The protocols for screening, tracking immediately put into place and the returnees contacts, systematic testing and limiting quarantined till proved negative. social contacts through quarantining, has stood Kerala in good stead, in its current The pro-active measures taken up by the grapple with the cross border biological State of Kerala covered a gamut of sectors, hazard. are worth showcasing as a success story, especially in the preliminary phase. The Both, Kerala State Disaster Management document is collection and compilation of Authority (KSDMA) and the Department of information from different sources and Health and Family Welfare, were in constant news. touch right from early January, when the first

3 | Kerala’s Tryst with COVID 19

with the help of Health Department and communicated through website and social media groups in the form of print material, sign language and audio visuals ROLE OF HEALTH DEPARTMENT Protocols & Advisories: a. The Department of Health and Family ROLE OF KSDMA: Welfare has been regularly bringing out a. Preliminary information on the viral Advisories on protocols on surveillance, infection in Wuhan, China issued by testing, screening, home based and KSDMA to Directorate of Health Services hospital- based quarantining and (DHS) based on message in National discharge. Each Advisory is based on the Disaster Management group on 19 current risk assessment and emerging January 2020. Need for public health matters of concern. surveillance was flagged to DHS b. The Dept of Health and Family Welfare b. Query from Ms. Neethu Rajan, IFS, Indian has also brought out two advisories for Embassy Beijing dated 29-01-2020, the Tourism Sector, one for the regarding China returnees attending Department of Animal Husbandry and public functions in was flagged to one for the Education Sector Additional Director (Public Health) and c. The Advisory for the AH Dept assigns the advisory on ban on China returnees responsibility of providing for feed, attending public function in India, was fodder and water for the cattle/ animals/ issued through DHS pets owned by the people under c. KSDMA State Executive Committee quarantine. Apart from the food security meeting notified Coronavirus as ‘State of the animals, the AH Dept is also Specific Disaster, designating Kerala responsible for monitoring the health of Health Department as the Nodal the animals and ensuring timely action. Department supported by Disaster d. The advisories for the tourism sector Management Department through its initially only related to international/ response mechanism and SDRF. The National visitors who had arrived from/ declaration as State Specific Disaster was transited through Wuhan/ China. Later, done to ensure that the entire machinery this Advisory was updated to include all of the state would be used for the international travelers and National containment of the virus. Travellers who had come/ transited d. However, subsequently on 07-03-2020, through high risk places as specified by declaration of Coronavirus as ‘State WHO. Specific Disaster’ was withdrawn after e. The Advisory for the Education Sector Health Department informed that the talks about dealing with children who likelihood of transmission and spread of have been in direct or indirect contact infection from the primary imported with the high-risk group of people, either cases has reduced. at hospital or at home. e. Funds, roughly amounting to rupees eight crore was allotted to Department of Health and Family Welfare for the provision of procurement of equipment and supplies that would help in the containment of the virus. f. Information on Dos and Dont’s of Coronavirus infection was developed 4 | Kerala’s Tryst with COVID 19

3. HOSPITAL BASED AND HOME-BASED QUARANTINE: a. Guidelines have been issued on the periods of quarantine recommended, based on high risk and low risk people. b. These Guidelines also specify the discharge protocols. 1. SCREENING: a. Screening was initially only for people 4. WORKING WITH THE LSGIS/ coming in from Wuhan/ China or any of KUDUMBASREE/ JAILS/ CBOS FOR the affected countries as specified by the BETTER RESOURCE MANAGEMENT: WHO Bulletins. a. Kerala has successfully co-opted the b. However, this was changed by early LSGIs for seamless monitoring of those March, when universal screening was put under surveillance or home-based in place at Airports quarantine. Such people are regularly c. Currently, there is screening at all mass contacted and supports provided, if need transportation centres, including Bus be. The people under self- quarantine are Stations and Railway Stations contacted regularly and all supports provided, including counselling support. 2. CONTACT TRACING b. The shortage of masks had started a. With previous experience of virus becoming a matter of concern, till the H & FW Dept roped in the jail authorities containment at hand, the state health and got the jail inmates to start stitching department initiated a massive tracking of masks. Some groups of Kudumbasree exercise to trace a person who met newly are also involved in making of masks. infected people. c. The Kerala Drugs Centre has started mass b. At the panchayat level, Asha and production of low- cost hand sanitisers. ‘kudumbashree’ workers have been All their staff have been involved in shifts asked to track if any people in their for producing these hand sanitisers

respective areas have come from abroad. 5. SOCIAL DISTANCING “Our officials traced those who It has been reported that China could have cut their virus infected deaths by returned to Kerala from infected areas half if they had pursued non- and isolated them even if they had pharmaceutical approaches like social minor symptoms. Some others were distancing. Kerala took steps early and home quarantined. Trained health ensured enforced social distancing workers were deployed to assist them. through the following steps: It was all a team effort. Luckily, Kerala

has a team of duty-bound officials and experts who managed the situation with extreme dedication and courage,’’ state health minister Shailaja told HuffPost India earlier this

month.

5 | Kerala’s Tryst with COVID 19

6. FOOD SECURITY AND NUTRITION Food Security and nutrition was considered, and arrangements made to ensure people did not suffer needlessly.

a. Anganwadi noon meals: Asha Workers and the Anganwadi Teachers were

tasked with ensuring that the noon meals were supplied to the children at home. EDUCATIONAL INSTITUTIONS This was mainly as week long dry rations. Cancelled classes for all educational b. People under self-quarantine: LSGIs institutions, except for the conduct of th th st were tasked with ensuring that food 10 and 12 examinations, till the 31 of supplies/ raw materials were made March. Pro-active measures were taken available to the people in self- quarantine to ensure that students who had fever/ at homes. cough or other symptoms, or were from homes with people under quarantine, 7. PLAN C- PREPARING FOR STAGE could attend these examinations in The State is already gearing up to face separated class rooms with all due Phase 3, if need be. precautions. a. The Department has already floated

adverts for more such para-medical or ANGANWADIS medically trained personnel to All anganwadis, nursery schools, day-care st strengthen field level surveillance and centres etc. are closed till 31 March. monitoring. b. They have identified additional facilities, OTHER PUBLIC SPACES especially private hospitals at Cinema Halls, Health Centres, Gyms, decentralized levels that can hold more Swimming Pools etc were closed until patients under surveillance/ isolation. further notice. Strict instructions were They have also identified other unused given on keeping social functions, facilities, that can, in a pinch, be used for especially marriages, low-key with not housing the affected. many invitees. Religious functions could be conducted but only the ritual without 8. STATE LEVEL CORONA VIRUS the accompanying feasts. Churches and CONTROL TEAMS UP Mosques were requested to reduce their Apart of the Special Cell that has been prayer time to half an hour. set up at State level for Control of Corona

Virus, 18 State level Teams also have been ASSEMBLY ADJOURNED (SOCIAL set up that independently head different DISTANCING) functions like Field Surveillance, Hospital On Friday, the Kerala Assembly was Surveillance, Testing, Material adjourned sine die in view of the virus Management, Data base management, outbreak. However, before adjournment, IEC etc. They support the State Level CV all the outstanding demands for grants, Control Cell. the Kerala Appropriation Bill and Kerala finance bills were passed without discussion

6 | Kerala’s Tryst with COVID 19

entrants for temperature. The RTO’s Office insists that all visitors were masks.

12. USE OF ROBOT On experiment basis Robots are used to give sanitizers and information (FAQs) The government nodal agency for entrepreneurship and incubation 9. INFORMATION SHARING activities has launched two robots a. There are regular meetings both in the developed by startup firm Asimov morning and evening to take stock of the Robotics to spread awareness about emerging situation and further planning arresting the spread of virus. One of the based on that. robots also distribute face masks, b. Apart from these internal meetings, sanitizer and napkins for better cough there are regular press meetings where hygiene. At the KSUM’s Integrated both the Chief Minister and the Health Startup Complex at Kalamassery, the Minister speak openly about the new other robot screens detail about the cases, the steps taken and the World Health Organization’s campaign precautionary measures to be to contain the epidemic. undertaken. They are balanced in their approach, not hiding any fact but at the 13. ROUTE MAPS same time, not creating any panic like Last week, district authorities began situation. c. They take all opportunities to caution the preparing route maps of the infected people on self- protection, need for hand people, which involves tracking every washing, maintaining distance from point from when the patient landed in other people etc. India or came in contact with an infected d. Route maps of the affected people are person, up to when they were admitted shown on public domain to help people to a hospital. The information gathered self- assess if they have had any contacts with the affected. If so, they can then call includes place and time. up or approach the closest health centre for advice. For a family of three that tested positive in Pathanamthitta, around 16 squads led 10. BREAK THE CHAIN CAMPAIGN by the District Collector and the District The latest intervention has been a much Medical Officer (DMO) travelled across publicized “Break- The Chain” Campaign, the district to identify the places visited promoting hand washing. Hand by the family and to track the contacts, a Sanitisers have been provided in all offices and posters put up asking people senior medical official of the state told to wash their hands when the enter an PTI. office and when they leave the office. Taps have also been provided in some “A flow chart was prepared with all the places public spaces to promote frequent hand visited by the family upon their return and washing. have been mentioned in a map, so that people can voluntarily inform authorities if they had 11. SCREENING, MASK UTILIZATION come in contact with them,” said minister Some public spaces like Malls, IT parks, Shailaja. Technopark have started screening the

7 | Kerala’s Tryst with COVID 19

ROUTE MAP RELEASED BY KERALA did it manually. Now we know they were there, GOVERNMENT and they are on our radar.”

The Minister told the state assembly on The News Minute details how local bodies Friday that the patient flow chart was have played a crucial role in this process. released as the family was not revealing all the details to the medical department.

The Pathanamthitta DMO told PTI that the authorities received hundreds of calls from various places in the district after the travel map was released.

Rathan Kelkar, Mission Director, National Health Mission, Kerala, who is heading the contact tracing team there, told , “When we published the Pathanamthitta flowchart we were contacted by 140 people, one of whom turned out to be a primary contact we missed to trace when we

8 | Kerala’s Tryst with COVID 19

14. QUARANTINE COMFORT 15. PSYCHO-SOCIAL SUPPORT / FOCUS ON MENTAL HEALTH While the Centre’s period of quarantine is 14 days, Kerala is quarantining people for 28 Psycho-Social Support: Additional days. counselling professionals were taken in at district level and Panchayath level to ensure The people who have been in quarantine in counselling support, mainly for those under the state have had positive things to home-based quarantine. say. Patients have talked about receiving their choice of meals, being provided wi-fi as The state opened multiple call centres to well as counselling. keep check on the mental health of those who are home quarantined.

Dr Amar Fetle, who is in-charge of the anti- Kerala’s first coronavirus patient, who has COVID-19 task force in Kerala, told The completed treatment and been discharged, Print, “A live counselling hotline is being told The News Minute, “In my 25 days in used to provide stress relief to the affected isolation, there were times when I would people. The mental health division is in feel depressed. She (the health inspector) constant contact with patients and giving would call and comfort me then. I was in them good psychological support. That touch with her from the time I had itself plays a big part in the recovery returned from Wuhan and the both of us process,” he added got very close. I would also speak to the counsellors who would cheer me up.”

16. VISITS FROM GOVT OFFICIALS health worker, police official and health volunteer will visit every home where persons The health minister herself has been visiting are quarantined and verify their status.” patients. Shailaja told HuffPost India many people had advised her against visiting 17. DAILY PRESS CONFERENCES patients in isolated wards. There are too many questions, sense of fear, “But I took it up as a responsibility. All anxiety among people. So many information, precautions have been taken but the collective which is true or false; whom to believe or not? will and determination finally started reaping In order to ensure sanity in the society and dividends. Patients, their families and the civil reduce panic and trauma, the Kerala society have cooperated with us in the fight,” government holds a press conference, she said. sometime led by Chief Minister Pinarayi Last week, the minister said health Vijayan or Health minister Shailaja or by volunteers and police would inspect those Senior Government Officials, every evening who are in home quarantine to ensure that with answers for any questions one may have they remain under isolation. about the outbreak, including details on the new cases that have been reported that day. To tackle those breaking quarantine, Shailaja said: “We have been keeping a tab on them While the media asks the government for through GPS tracking and have found some of clarifications it may need, the ministers also them sneaking out. A team consisting of a use this time to announce updates or news 9 | Kerala’s Tryst with COVID 19

measures they are taking in view of medical shops around the country after outbreak’s expansion. Government has people began panicking and hoarding them. directed media houses to stop the spread of rumours through their columns. The CM 20. APP TO COMBAT FAKE NEWS often uses the opportunity to caution people While the state’s police have been directed to against spreading fake news or unverified take stringent action against those spreading information on COVID-19, being kind to fake news, on Friday the Kerala government tourists who may be stranded in the state, launched its app GOK Direct to disseminate and advocating for the centre to take steps information and updates on the outbreak. to ensure the safe return of Indians stranded The app is available for Android and iOS users in the worst-affected countries. and sends SMS alerts to phones that don’t The press conference is held in a calm and have internet. measured manner, with assurances to people APP Link that there is no need to panic but exhorting them to remain vigilant and follow 21. MID-DAY MEAL DELIVERY advisories. As the government announced on March 10 18. INCREASING INTERNET that all classes, including at madrasas, CONNECTIVITY anganwadi centres and private tutorial institutions, would remain closed till the end Last week, the state government announced of the month, the CM assured that the that it was working with internet service government would home-deliver the mid-day providers to increase connectivity by 30- meals provided at anganwadi centres across 40% in the state to meet the surge in demand, the state. likely to be of relief to people who are quarantined or need to work from home. This The move has received widespread praise. measure was widely praised on social media Taking a cue from this, the as one of the unconventional ways in which government said it would deliver groceries to the government was thinking for the long the homes of children studying in term. anganwadis while they remain shut this week. 19. SANITISER PRODUCTION 22. CHECKING RAIL AND ROAD ENTRY The Kerala State Drugs and Pharmaceuticals POINTS Ltd, a public sector undertaking, has assured the state government it would produce As new cases were being reported in the enough sanitisers for the state. state, Kerala government launched intensified medical check-ups at 24 spots “The Kerala state drugs and pharmaceuticals bordering Tamil Nadu and Karnataka for limited has informed the government that people entering the state by rail and road. they had started manufacturing sanitisers for distribution in the state. They told us that they can produce one lakh bottles within ten days,”

Vijayan said.

KSDP will sell these for Rs 125 for a 500 ml bottle. Sanitisers are not available in many

10 | Kerala’s Tryst with COVID 19

“A special team will monitor all the passengers of inter-state trains at the first station inside Kerala borders. The team will comprise one paramedical staff, a policeman and a local volunteer and they can examine two bogies at a time. For example, if there are 12 bogies for a train, there will be six such teams to examine all passengers,” said the Chief Minister

The train passengers would also get an SMS The state government has also identified 24 alert, saying they would be checked at the points in the border road areas of Kerala first station the train touches after entering from north to south and a separate team, Kerala. headed by a Deputy Superintendent of Police (DySP) will monitor those who travel by vehicles.

“We know that all these restrictions pose so much trouble to the people. But since we are going through an extraordinary situation, we request everyone to cooperate with the officials. It’s in the best interests of the state and the people,” said the Chief Minister.

23. AWARENESS AMONG MIGRANT 25. ENLISTING VOLUNTEERS FOR HELP WORKERS With 22 confirmed cases of Covid-19, the Vijayan said, “We have asked the officials to state has enrolled volunteers to assist the visit migrant labour camps in the state and health department after special training by create awareness among them by using those officials. who can speak their language. We have also The response to call for volunteers has been given instructions to keep their localities “overwhelming”, Kelkar said. He added, “We clean.” needed additional volunteers for ensuring the 24. BREAK THE CHAIN INITIATIVE medical check-ups of passengers coming through the border. We have received many On Sunday, the health department launched requests and will provide them appropriate a “breaking the chain” campaign to training.” encourage hand sanitising among people in order to prevent the spread of coronavirus. 26. BATTING AND PREPPING FOR FOREIGN ARRIVALS “There are chances of the virus being spread through our hands. Sanitising our hands will The state government is closely working with break the chain and prevent the spread of the Union Government to bring in Indians virus. We must use hand sanitisers or wash the (specially Keralites) who are stranded in hands with soap and maintain personal other countries. The state government has hygiene. We need to spread awareness on also sought the assistance of the Centre to hand hygiene campaign,” Vijayan said. help the expatriates, using diplomatic intervention, to extend the Visa and leave

those who are in the country, which are impacted drastically. 11 | Kerala’s Tryst with COVID 19

LINK TO VARIOUS AWARENESS  https://www.facebook.com/Kera POSTS OF KSDMA laStateDisasterManagementAut horityksdma/photos/pcb.269858  https://www.facebook.com/Kera 3553569008/2698583520235678/ laStateDisasterManagementAut ?type=3&theater horityksdma/photos/a.94358987 9068393/2713893925371304/?typ  https://www.facebook.com/Kera e=3&theater laStateDisasterManagementAut horityksdma/photos/a.94358987  https://www.facebook.com/Kera 9068393/2698355563591807/?ty laStateDisasterManagementAut pe=3&theater horityksdma/photos/a.94358987 9068393/2703321349761895/?typ  Link to sign language awareness e=3&theater video: https://youtu.be/3CUcZem8YDE  https://www.facebook.com/Kera

laStateDisasterManagementAut horityksdma/photos/a.94358987 Sources of Pictures 9068393/2703319846428712/?typ e=3&theater  The Logical Indian - https://thelogicalindian.com/good-  https://www.facebook.com/Kera governance/kerala-home-delivery- laStateDisasterManagementAut internet-coronavirus-20132 horityksdma/photos/a.94358987  9068393/2699238913503472/?typ e=3&theater https://www.newindianexpress.com/s tates/kerala/2020/mar/09/  https://www.facebook.com/Kera coronavirus-kerala-family-that- laStateDisasterManagementAut landed-from-italy-hid-vital- horityksdma/photos/pcb.269858 information-to-slip-through-the- 3553569008/2698583410235689/ system-2114180.html ?type=3&theater  The Epoch times -  https://www.facebook.com/Kera https://www.theepochtimes.com/hon laStateDisasterManagementAut g-kong-reports-first-death-from- horityksdma/photos/pcb.269858 coronavirus_3226454.html 3553569008/2698583430235687/  https://www.pinterest.de/pin/647399 ?type=3&theater 3198855564/

12 | Kerala’s Tryst with COVID 19